heart murmurs Flashcards
what are the characteristics of an innocent and pathological murmur
innocent
- systolic always
- localised
- soft <3/6
- varies with psotition and respiration
- no thrill or heave
- no sx of HF
pathological - pan systolic or diastolic - radiates - harsh or long - thrill associated sx or signs of HF
what defects present with HF
VSD
AVSD
PDA
what defects present with murmur
ASD
pulmonary stenosis
what defects present with shock
aortic stenosis
CoA
what defects present with cyanosis
TOF
TGA
what is the most common murmur
VSD
describe a VSD and the murmur heard
L-R
harsh pansystolic murmur at L sternal edge
most common 32%
present with HF at 4-6wks of age
describe a AVSD
Downs syndrome 40%
HF
describe a PDA and murmur heard
machinery like murmur more common in premi bounding pulse HF Mx: PGE inhibitor, diuretics
describe ASD
mostly asymtpomatic
split s2
recurrent chest infection
describe pulmonary stenosis
ejection systolic murmur with click poor exercise tolerence RVH and RVF ECG - RAD, RVH Mx: balloon dialtion
describe CoA
pre-ductal or post-ductal
present at couple days of life when duct closes over
hypertension in upper limbs, hypotension in lower limbs
absent/weak femoral pulses
Mx: balloon dilation, PGE2
associated with turners syndrome
describe aortic valve stenosis
ejection systolic murmur
syncope, decreased exercise tolerance
describe tetralogy of fallot
- RVH
- VSD
- overriding aorta
- pulmonary outflow obstruction
kids often squat down as this increases the LV pressure
booted shaped heart
describe TGA
present very unwell
low O2sat not affected by high flow o2
present couple days of life when duct closes over
Mx: PGE, resp and circulatory support, atrial septostomy before switching procedure
